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Clinical and immunological relevance of anti-neuronal antibodies in celiac disease with neurological manifestations.

Caio G, De Giorgio R, Venturi A, Giancola F, Latorre R, Boschetti E, Serra M, Ruggeri E, Volta U - Gastroenterol Hepatol Bed Bench (2015)

Bottom Line: Neurological manifestations are estimated to occur in about 10% of celiac disease patients and NA to central nervous system (CNS) and enteric nervous system (ENS) are found in a significant proportion of them.NA to CNS and ENS were found in 7% and 5% of controls, respectively.High titer NA to ENS are associated with severe constipation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical and Surgical Sciences, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy.

ABSTRACT

Aim: To assess anti-neuronal antibodies (NA) prevalence and their correlation with neurological disorders and bowel habits in celiac disease (CD) patients.

Background: Neurological manifestations are estimated to occur in about 10% of celiac disease patients and NA to central nervous system (CNS) and enteric nervous system (ENS) are found in a significant proportion of them. Little is known about the clinical and immunological features in CD patients with neurological manifestations.

Patients and methods: NA to CNS and ENS were investigated in 106 CD patients and in 60 controls with autoimmune disorders by indirect immunofluorescence on rat / primate cerebellar cortex and intestinal (small and large bowel) sections.

Results: IgG NA to CNS (titer 1:50 - 1:400) were positive in 23 celiacs (21%), being more frequently detected in those with neurological disorders that in those without neurological dysfunction (49% vs. 8%, P< 0.0001). Of the 26 celiacs (24%) with IgG NA to ENS, 11 out of 12 with an antibody titer > 1:200 had severe constipation. Only one patient with cerebellar ataxia and intestinal sub-occlusion was positive for NA to CNS and ENS. NA to CNS and ENS were found in 7% and 5% of controls, respectively.

Conclusion: In CD the positivity of NA to CNS can be regarded as a marker of neurological manifestations. High titer NA to ENS are associated with severe constipation. The demonstration of NA to CNS and ENS suggests an immune-mediated pathogenesis leading to central neural impairment as well as gut dysfunction (hence constipation), respectively.

No MeSH data available.


Related in: MedlinePlus

Prevalence of NA to CNS in the whole group of celiac disease patients vs. autoimmune controls (P<0.05, two-tailed Fisher’s exact test). Abbreviations: CD: Celiac disease; CNS+: NA to CNS; CTRL: controls.
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Figure 3: Prevalence of NA to CNS in the whole group of celiac disease patients vs. autoimmune controls (P<0.05, two-tailed Fisher’s exact test). Abbreviations: CD: Celiac disease; CNS+: NA to CNS; CTRL: controls.

Mentions: A bright staining in the myenteric and submucosal plexuses of the rat ileum and colon represents the typical pattern of NA to ENS (Figure 2). NA to CNS were found in 23 (21%) of the whole group of the 106 CD patients in comparison with their positivity in 4 (7%) of the 60 controls with autoimmune disorders (P< 0.05 (Figure 3).


Clinical and immunological relevance of anti-neuronal antibodies in celiac disease with neurological manifestations.

Caio G, De Giorgio R, Venturi A, Giancola F, Latorre R, Boschetti E, Serra M, Ruggeri E, Volta U - Gastroenterol Hepatol Bed Bench (2015)

Prevalence of NA to CNS in the whole group of celiac disease patients vs. autoimmune controls (P<0.05, two-tailed Fisher’s exact test). Abbreviations: CD: Celiac disease; CNS+: NA to CNS; CTRL: controls.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4403027&req=5

Figure 3: Prevalence of NA to CNS in the whole group of celiac disease patients vs. autoimmune controls (P<0.05, two-tailed Fisher’s exact test). Abbreviations: CD: Celiac disease; CNS+: NA to CNS; CTRL: controls.
Mentions: A bright staining in the myenteric and submucosal plexuses of the rat ileum and colon represents the typical pattern of NA to ENS (Figure 2). NA to CNS were found in 23 (21%) of the whole group of the 106 CD patients in comparison with their positivity in 4 (7%) of the 60 controls with autoimmune disorders (P< 0.05 (Figure 3).

Bottom Line: Neurological manifestations are estimated to occur in about 10% of celiac disease patients and NA to central nervous system (CNS) and enteric nervous system (ENS) are found in a significant proportion of them.NA to CNS and ENS were found in 7% and 5% of controls, respectively.High titer NA to ENS are associated with severe constipation.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical and Surgical Sciences, University of Bologna and St. Orsola-Malpighi Hospital, Bologna, Italy.

ABSTRACT

Aim: To assess anti-neuronal antibodies (NA) prevalence and their correlation with neurological disorders and bowel habits in celiac disease (CD) patients.

Background: Neurological manifestations are estimated to occur in about 10% of celiac disease patients and NA to central nervous system (CNS) and enteric nervous system (ENS) are found in a significant proportion of them. Little is known about the clinical and immunological features in CD patients with neurological manifestations.

Patients and methods: NA to CNS and ENS were investigated in 106 CD patients and in 60 controls with autoimmune disorders by indirect immunofluorescence on rat / primate cerebellar cortex and intestinal (small and large bowel) sections.

Results: IgG NA to CNS (titer 1:50 - 1:400) were positive in 23 celiacs (21%), being more frequently detected in those with neurological disorders that in those without neurological dysfunction (49% vs. 8%, P< 0.0001). Of the 26 celiacs (24%) with IgG NA to ENS, 11 out of 12 with an antibody titer > 1:200 had severe constipation. Only one patient with cerebellar ataxia and intestinal sub-occlusion was positive for NA to CNS and ENS. NA to CNS and ENS were found in 7% and 5% of controls, respectively.

Conclusion: In CD the positivity of NA to CNS can be regarded as a marker of neurological manifestations. High titer NA to ENS are associated with severe constipation. The demonstration of NA to CNS and ENS suggests an immune-mediated pathogenesis leading to central neural impairment as well as gut dysfunction (hence constipation), respectively.

No MeSH data available.


Related in: MedlinePlus